Transitioning to LTC, Part 1
One of the more difficult experiences a family faces is choosing to place a loved one in a Skilled Nursing Facility for long-term care. SLPs in long-term care meet families almost daily who are experiencing worry, fear, guilt, anxiety, and possibly even anger - at themselves, at loved ones, and at other causes of the need to seek long-term placement.
Some residents have chosen the move to long-term care on their own, as they realize that are not able to care for themselves at home, and that family members are also unable to provide adequate assistance. While these residents do usually go through a period of adjustment, or even mourning, for their old life and routine, it is often the confused resident who has the most difficult time adjusting.
Whatever the level of the patient physically or cognitively, providing a few suggestions for the transition can make it go more smoothly, and, ideally, the resident and their family would have these suggestions in order to plan ahead. I often set goals for memory, organization and orientation for new patients, and a little pre-planning or initial setup can help the patient to integrate into the new environment.
This week, let's focus on high-level patients with less severe cognitive deficits. These are also often helpful to patients with no cognitive deficits. Here's how you can help them adjust:
- Bring pictures, photo albums and a few favorite knick-knacks, but avoid trying to fit a household into a single room.
- Discuss your loved one's preferences, or have him write them down, early on with staff, including typical schedule, social habits (Will they enjoy having a talkative roommate? Are they a morning person? Are they a joiner, or a more solitary type?), food dislikes, favorite activities, etc.
- Ask about bringing the patient's own bedspread and pillows.
- Ask about bringing preferred toiletries. Male resident might appreciate their electric razor instead of disposable razors, and women may be very particular about shampoo and soap.
- Ask about bringing preferred foods and snacks, and where they can be kept. Can the residents have a mini-fridge?
- Set up an easy-to-read address book with contact information for all family members and as many friends as possible. Provide stationery, envelopes, and stamps. Find out about phone service, and teach the patient to use a simple pre-programmed cell phone before arrival, if needed.
- Tell her friends from social groups, community organizations and church where the patient will be, what the visiting policies are, and how the patient can be reached by phone.
- Plan ahead for specific days when family and friends will visit, especially during the first few weeks. Avoid having too many visitors arrive at one time, and offer to drive elderly friends to visit once in awhile.
- Notify magazines, charitable organizations, community organizations, and church groups of the move so he can stay in touch and continue to receive mail.
- Find out about policies for visitations by pets. Most facilities are able to allow pet visits!
- Expect some sadness and tearfulness, even if the patient has chosen on his own to live in the facility.
- Organize any important paperwork and decide where it will be kept: in a safe deposit box, with a family member, etc. Write down where it will be. This is especially important for patients in the early stages of dementia who might become more confused later, and might become anxious about finances and documents. Start a notebook for the patient that includes any important information they might want to have on hand.
Next week, I'll offer some suggestions for transitioning patients with more severe cognitive decline into the SNF environment.